From the Editor

We must continue disseminating robust, high-quality research and evidence-based innovations that challenge and expand our teaching practices to ensure that the next generation of nurses and nurse educators are well prepared and ready to educate students to improve global health. I welcome diversity of thought and perspective, as well as scholarly dialogue and debate as NEP transitions into the next decade. Weexperience many transitions in the course of our lives: from nursing student to expert clinician, from expert clinician to novice educator, from novice educator to master teacher, and from novice researcher to funded investigator. Transitions take time (Schlossberg, 2011) and can be stressful as we face new demands and challenges.Meleis (2010) defined transition as “a passage from one fairly stable state to another fairly stable state...characterized by different dynamic stages, milestones, and turning points” (p. 11). Meleis described these stages as a process related to change and development that can be empowering and growth producing but also accompanied by uncertainty— a time to reflect on where we have been and to consider future possibilities. She noted that the process of transition is essentially positive. Nursing Education Perspectives (NEP) is in a time of transition. Reflecting the National League for Nursing’s (NLN) dedication to excellence in nursing education, NEP, led by Dr. Joyce J. Fitzpatrick as editor, has long been at the forefront of disseminating topics of relevance to nurse faculty and leaders in nursing education. But with the start of 2020, after 22 years in the role, Joyce stepped down asNEP editor. As we bid her adieu, let us reflect on the role Joyce has had in the journal’s growth and maturation. Joyce was named editor of the NLN journal, then titled Nursing and Health Care Perspectives, in January 1998. At that time, we published three to four main articles per issue, with a general emphasis on community health, service-learning, and nurse-managed academic clinics, and the size of the journal never exceeded 48 pages, including advertisements. To reflect the renewed focus in the NLN mission on nursing education, the NLN Board of Governors in 2001 renamed the journal Nursing Education Perspectives. The new title first appeared in the January-February 2002 issue. At that time, there was only an occasional article on research in nursing education— for example, that first issue with the new title included “A Comparison of Student-Centered Versus Traditional Methods of Teaching Basic Nursing Skills in a Learning Laboratory” by Dr. Pamela Jeffries and colleagues (Jeffries, Rew, & Cramer, 2002). As the NLN clarified its mission and goals to advance the science of nursing education, the landscape of research in nursing education exploded, Joyce became more and more selective in soliciting manuscripts that reported on rigorous multisite research studies. She steered the transformation of the NLN official journal into what it is now, the research journal of the NLN and the premier nursing education journal for scholarship in nursing education.

e increase of obesity in children and young people across the globe is becoming a challenge for the medicine of today. e task is very serious and di cult when taking into consideration the consequences of obesity: health problems (cardiovascular diseases, diabetes type 2 etc.), as well as psychosocial and economic implications. e origin and mechanisms underlying the rapid increase of obesity in children is complex and not very well known, therefore successful prevention and treatment are di cult. In this situation reguired is a multidisciplinary team ensuring good cooperation of di erent specialists in order to develop a programme of prevention involving a diagnosis and treatment procedure. As we have already stressed, it is a very di cult task and up to now the results achieved are not satisfactory enough.
In 2014 the European Commission launched the EU Action Plan on Childhood Obesity 2014-2020 in Europe, which is based on eight key areas for action: 1) Support a healthy start in life; 2) Promote healthier environments, especially in schools and pre-schools; 3) Make the healthy option the easier one; 4) Restrict marketing and advertising to children; 5) Inform and empower families; 6) Encourage physical activity; 7) Monitor and evaluate; 8) Increase research. e WHO European Food and Nutrition Action Plan 2015-2020 moreover included the task concerning the adoption of comprehensive intervention and community-based initiatives to improve nutrition and prevent overweight and obesity among pre-school and school-aged children.
Overweight and obesity in children and adolescents is the subject of ongoing research projects. Many strategies for coordination or integration and dissemination of research ndings and turning them into innovative actions are undertaken at international level. Some examples of these activities are the European Childhood Obesity Group (ECOG) which was established in 1990, or the Child Obesity Task Force (COTF) formed within the framework of the European Association for the Study of Obesity (EASO) in 2000. A member of ECOG, Professor Marie-Laure Frelut was kind enough to write the editorial for this issue of Developmental Period Medicine presenting the progress and challenges in tackling child and adolescent obesity*. In 2016 the WHO Regional O ce for Europe established the Childhood Obesity Surveillance Initiative (COSI) in more than half the countries in the European Region. e aim of the Initiative is to measure trends in overweight and obesity in children aged 6.0-9.9 years to get a clear understanding of the epidemic and to allow inter-country comparisons. Data concerning the prevalence of overweight and obesity among 11-15-year-

F ROM TH E E DI TOR
olds are collected every four years within the framework of Health Behaviour in School-aged Children (HBSC), a WHO collaborative cross-national study which has been in place since 2002. In the last survey (2013/14) 44 countries or regions participated in this study.
Also in Poland many initiatives on prevention, management and research concerning childhood obesity were undertaken. e Institute of Mother and Child participated in the HBSC study (some data are presented in two articles in this issue) and the COSI project. e Children's Memorial Health Institute carried out a nationwide epidemiological study on the prevalence of overweight and obesity among children and adolescents aged 2-19 years (OLA and OLAF study). e Institute of Food and Nutrition carried out research and coordinated broad actions on obesity prevention among pregnant women, children and adolescents within the framework of the Project Supported by a Grant from Switzerland through the Swiss Contribution to the Enlarged European Union. In e National Health Programme 2016-2020 the rst of its six operational aims is: "Improvement of nutrition, nutritional status and physical activity of society". Many tasks included in this aim created the basis for childhood obesity prevention and therapy activities undertaken by di erent sectors.
In appreciation of the need for a multi-faceted approach to the prevention, management and therapy of childhood obesity, this edition of "Developmental Period Medicine" features a series of articles prepared by specialists from di erent disciplines. e articles can be divided into the following broadly conceived groups (some of them overlapping):

EPIDEMIOLOGY
In the article written by A. Grajda et al., based on the results of the nationwide OLAF study, di erences in the prevalence of overweight and obesity among children aged 6-19 years in di erent regions are analyzed. It was showed that in the region of Eastern Poland with GDP per capita below 80% of the national average, the prevalence of these disorders was lower (14.7%) in comparison with the rest of the country (16.4%).

DETERMINANTS
• GeneƟc e genetics of obesity -its pathogenetic, clinical and diagnostic aspects are presented by A. Barczyk, E. Obersztyn et al. Based on the results of multi-center studies three types of genetically conditioned obesity are broadly described: isolated, monogenic obesity; syndromic monogenic obesity associated with dysmorphic features and/or congenital defects caused by mutation in speci c gene(s); chromosomal aberrations, including submicroscopic changes. e neuro-endocrinological regulation of hunger and thirst, the clinical consequences of mutation in genes associated with the melanocortin pathway and the features of the most common obesity syndrome, as well as the diagnostic algorithm for cases of suspected syndromic obesity is presented.

• NutriƟon
Appropriate dietary patterns in children determines their optimal development, therefore playing a very important role. e investigation conducted by H. Weker, M. Barańska et al has shown that the diet of overweight toddlers di ers from the safe nutrition model in a very evident way. e solution is to implement nutritional education (H. Weker, M. Barańska et al).

• Microbiota
Obesity and microbiota. e role and function of the gut microbiota in contributing to the pathogenesis of obesity and the metabolic syndrome is presented by A. Karney.

• Psychology
Psychological determinants. e role of the mother-child relationship, speci c characteristics of the relationships; children's body experiences and certain body image distortions are described as psychological mechanisms involved in the onset and maintenance of childhood obesity (J. Radoszewska). A. Dzielska et al. present the Polish version of " e Physical Appearance Comparison Scale" (PACS), which may be used as a reliable and valid tool in the diagnosis and management of adolescents with excess body mass.
• Physical acƟvity e lack of physical activity plays an evident role in the increase of obesity. Based on the literature review and own experiences W. Osiński and A. Kananista describe very useful practical recommendations regarding the planning, implementing, and monitoring of intervention programmes involving controlled physical activity aimed at the reduction of adipose tissue. e analysis of the data from the HBSC study presented by D. Kleszczewska et al. showed that the percentage of overweight 15-year-olds in Poland was lower than the international average, but the percentage of adolescents, especially girls, who consider themselves too fat, was much higher. e level of discrepancies between objective and subjective assessment of body mass depends on geographical and cultural di erences, and the level of physical activity modi es these discrepancies. e perceived barriers to physical activity in adolescents and their association with motivation are presented by M. Jodkowska et al. It was found that three barriers (lack of energy, skills and willpower) and the perception of several barriers occurring simultaneously were reported more frequently by overweight adolescents than their peers with normal body mass. Motivation was a key element of perceiving these barriers.

CONSEQUENCES OF OBESITY
Two papers present the metabolic consequences of obesity related mainly to increasing the risk of atherosclerosis and cardiovascular diseases and diabetes type 2. In the group of obese children dyslipidemia, high insulin level and carotid intima-media thickness (IMT) were higher than in the control group (A. Karney et al).
e concentrations of low-density lipoprotein (LDL) and vitamin A in obese children were higher than in children with normal body mass (J. Gajewska et al).

THERAPEUTICS STRATEGIES
A combined mode of therapy of obese children and adolescents consisting of behavioral, dietary counseling (Dietary patterns in toddlers with excess weight 2016 Pitnats study -H. Weker, M. Barańska et al) with appropriate physical activity and using both modern media and devices are described by A. Zachurzok et al. It was stressed that successful therapy required good cooperation of the therapeutic team with the children and their parents. e editorial board believes that the papers presented in the present issue will be interesting and useful for di erent professionals working with young obese people and will stimulate research in this eld. An additional value are the lists of references included in the articles presented.